Lymphomegaly and Intestinal Thickening

Presented by: Rebecca McIntosh June 22, 2011 NCSUUltrasound Rotation

SignalmentCanine 6 year oldEnglish SetterWhite and BlackIntact femaleHunting/breeding

Presenting ComplaintAnorexia, vomiting

7 days durationDiarrhea, weight loss

6 weeks

HistoryApril 2011

Had litter of puppies3 survivedTreated with Cephalexin for diarrhea

May 22 Became anorexic

May 24 Began vomiting, hypoalbuminemic on

bloodwork

HistoryMay 28

Barium study performedShowed mild irregular, rough appearing

mucosa of stomach and SIStarted on Baytril Given Dexamethasone SP

May 30Presented to NCSU SAES

Physical ExamAbdomen tense on abdominal palpationNo peripheral lymphadenopathyRemainder of PE unremarkableBCS 3/9No melena on rectal

Diagnostic ImagingLateral abdominal radiograph

Loss of serosal detailMass effect in cranial abdomen

Remainder of radiographs aborted at owner’s requestAbdominal ultrasound strongly recommended

Differential DiagnosisNeoplasiaGI Foreign BodyInflammation -IBD

Diagnostic ImagingAbdominal Ultrasound

Diagnostic ImagingAbdominal Ultrasound

Diagnostic ImagingAbdominal Ultrasound

Diagnostic ImagingNormal Bowel

Diagnostic Imaging

Diagnostic ImagingAbdominal Ultrasound

Diagnostic ImagingAbdominal Ultrasound

Diagnostic ImagingAbdominal Ultrasound

Diagnostic ImagingAbdominal Ultrasound

Normals

40mm

<7.5mm

5-10mm

<25mm

3-4mm

<3mm

5-10mm

<5mm

Diagnostic ImagingAbdominal Ultrasound

Normals

40mm

<7.5mm

5-10mm

<15mm

5mm

5-10mm

<50mm

Diagnostic ImagingAbdominal Ultrasound-typical finding

Differential Diagnosis-revised LymphomaIBD

DiagnosticsLN Aspirates

Large granular lymphomaMost commonly splenic in origin

ConclusionOwner elected euthanasia

No necropsy was performed

Acknowledgements:Dr. PhillipsDr. CampbellDr. DuhadwayAmerican Cancer Society

http://www.cancer.org/Cancer/SmallIntestineCancer/DetailedGuide/small-intestine-cancer

Questions ?